It's only August, but I'll go out on a limb and congratulate the
Village Voice's Keith Harris for what I feel confident will stand
the test of time as the stupidest comment of the year. "Because his
vision of rock and roll is so grand, Springsteen requires a popular
consensus as surely as any invasion of Iraq. And as we've learned yet
again, nothing sparks phony consensus like national cataclysm. Maybe
that's why, for the past few days, a nagging thought has burrowed into
my brain that I wish was merely the snide aphorism I initially took it
for: If there hadn't been a September 11, Bruce Springsteen would have
had to invent one."

Like an Ann Coulter bestseller or a Rush Limbaugh radio rant, Harris's
review is idiotic but instructive. Aside from its self-evident (and
self-incriminating) silliness, what galls about the comment is its
willful forfeiture of the common cultural ground upon which Bruce
Springsteen plies his trade. Does 9/11 belong only to George Bush and
Donald Rumsfeld? Is American popular culture the exclusive preserve of
Spielberg, Bruckheimer and Britney?

While managing to keep both feet planted in the mainstream, Springsteen
has done more than any American artist to give voice to the American
"other" that pop culture would prefer to forget: the humiliated Vietnam
veteran, the fired factory worker, the hunted illegal immigrant, the
death-row inmate, the homeless person living beneath the bridge and
Amadou Diallo, a West African immigrant, accidentally murdered by
forty-one shots from New York's finest. With his 1994 AIDS ballad
"Streets of Philadelphia," Springsteen became the first heterosexual
rock star ever to sing in the voice of a homosexual man, in a work
that--as Ann Powers, who was then writing brilliant music criticism in,
uh, the Village Voice, observed--succeeded in crossing "the
barriers of class, race, and gender."

Springsteen is vulnerable to criticism on any number of grounds,
artistic and commercial, but his willingness to offer solace in troubled
times strikes me as pretty low on that list. Springsteen was literally
stopped in his car after 9/11 by someone who cried out, "We need you."
Monmouth County, where he lives, lost 158 people in the towers. He
played a couple of local benefits. He read, repeatedly, about the
meaning of his work to his fans in the New York Times's
"Portraits of Grief." He called a few widows, shared their stories and
made a record. It's what he does. "I have a sense of what my service to
my audience is going to be," he explains. "It's the true nature of work
in the sense that you're filling a place. And that place comes with its
blessings and its responsibilities." So sue him.

It is a separate question as to whether one thinks the art that emanated
from this impulse is wholly successful. With regard to The
Rising, I can argue the point either way. But to take issue with the
very idea that art can be a balm to those in pain--or, as Springsteen
puts it, "music is medicine"--is cynicism itself. And to the degree that
this is at all representative of leftist attitudes, it speaks for an
impotent and self-defeating left: too smug and self-satisfied to engage
the culture of the common people, preferring instead to smirk on the
sidelines.

Granting both its sincerity and its (inconsistent) genius, The
Rising does nevertheless raise some complicated questions about art,
politics and commerce. One has to go back to 1984--to Springsteen's ownBorn in the U.S.A.--to find a rock record that was marketed as
energetically to mainstream America. After decades of relative
reclusiveness, Springsteen is suddenly everywhere in the mass media:
taking over the Today show in Asbury Park, on David Letterman two
nights in a row, ditto Ted Koppel, on MTV, Saturday Night Live,
simultaneous covers of Time and Rolling Stone; long
interviews with the New York Times, the LA Times andUSA Today. I half expected him to duet with Elmo or Big Bird over
breakfast. It should surprise no one that the record entered the charts
at No. 1 in eleven countries.

The problem arises--just as it did with Born in the U.S.A.--when
the work's cultural signification overwhelms its artistic essence; what
Nietzsche, in Twilight of the Idols, termed "the thing itself."
The dilemma for anyone who seeks to use popular culture to communicate a
message at odds with its market-driven heart of darkness is: who's using
whom? Did Springsteen accidentally empower Reaganism back in the
mid-1980s as he simultaneously denounced it? Is he somehow cheapening
the individual tragedies of which he writes and sings by performing
these haunting melodies at the ungodly hour of 8:30 am in the happy-talk
context of a Today show beach party?

Matt Lauer asked Springsteen whether he feared being accused of
exploiting the tragedy of 9/11, and Springsteen told him to listen to
the music and make up his own mind. The same might be said of his
willingness to embrace (and exploit) America's mighty mass-marketing
machine.

The answer has to be a personal one. In Asbury Park, I did some random
interviewing of people who had traveled many hours, and waited on
overnight lines, in the hope of seeing Springsteen perform four songs in
the Convention Hall for the Today broadcast. I spoke to a
firefighter who had gone into the burning buildings, a 16-year-old girl
who was repaying her mom for waiting ten hours on line to get 'NSync
tickets, a woman with her 5-year-old son, who, back in '85, enlisted her
entire family in a weeklong wait for tickets. Nobody mentioned Matt or
Katie. Nobody mentioned the marketing campaign. Nobody even complained
about the all-night wait and the uncertainty that they would be allowed
inside the hall. They were there for Bruce because Bruce was there for
them. In the midst of what Springsteen accurately terms "a theater of
humiliation on TV and on the radio, a reflection of self-loathing," they
had created a community around something better. This was their
hometown.

The recent news about the harmful effects of hormone replacement was
played in the media as a health story, but it is much more than that. In
fact, it may be the hot-flashiest corporate scandal to date: Let's call
it Estron.

If other corporate scandals have been about fudging figures, this one
is about fudging science--something that seems to have been surprisingly
easy to do. And such is the corporate culture that we have apparently
preferred to believe the drug companies rather than the women's health
advocates who have been lobbying for decades simply to get the
scientific evidence to back the companies' claims. The director of the
North American Menopause Society (NAMS), Dr. Wulf Utian, called the bad
news about hormones a bombshell, but it really isn't. Information has
been slowly accumulating about hormone replacement therapy's risks, even
as Wyeth and other manufacturers have been pushing their product as an
elixir for a widening group of symptoms. In recent years, this
potentially carcinogenic drug has been marketed with the nonchalance of
a vitamin pill: HRT advertising suggests that almost no woman over 50
couldn't benefit from it somehow.

Estron is the latest in a long line of scandals pitting women's health
against the interests of Big Pharma--scandals like the sale of faulty
Dalkon Shield contraceptives, which caused infertility, and medications
like DES, which caused severe illnesses in users and their children.
What all these cases have in common is that--like the manufacturers of
menopausal hormones--the drug companies, in their rush for profits,
insufficiently tested their wares before selling them to millions. What
these scandals suggest is that somewhere in the swampy landscape of
medical research funding, unhealthy relationships incubate between
medical practitioners and the drug-company reps who manage to dazzle
them with quasi science and quasi truths. The industry spends around $15
billion a year to promote its products--more than it spends to develop
them. Clearly, even those doctors who resisted the
luxury-cruise-lectures approach to sales found themselves suckered in.

The manipulation of HRT's scientific credentials began back in the
mid-1960s, when Wyeth paid gynecologist Dr. Robert Wilson to extol its
new wonder drug, estrogen replacement. In an evocatively named book,Feminine Forever, Wilson declared that by replacing the estrogen
lost at menopause, women would remain attractive and easier to live
with. Over the decades since, Wyeth and other hormone manufacturers have
revised dosages and combinations to fit new medical revelations and
poured billions into sophisticated propaganda to get their message out.
The message is that menopause is not a natural life stage but a
disease--estrogen deficiency--and it will make you old. HRT is the cure,
and it will keep you young.

In recent years the manufacturers have claimed protective qualities for
HRT way beyond its original ambitions. First, it promised (and
delivered) relief from menopausal symptoms. Next came claims for
protection against heart disease in women already affected, and then in
healthy women. Then came its role as a treatment against osteoporosis,
which, manufacturers warned (falsely), becomes an instant risk at the
moment of menopause (it's a gradual risk over many years).

The truth is that the manufacturers didn't exactly know what HRT did or
didn't do, because they never ran a big, randomized national study
stringent enough to meet medical standards. For more than twenty years,
the companies used observational studies showing that women who took
hormones were healthier, but they didn't look at why: Was it that the
hormones themselves made women healthier, or that health-conscious women
were more likely to take hormones to begin with? There were many other
uncertainties. Yet calls to answer these questions, from women's health
groups and even from prominent politicians like Pat Schroeder and
Olympia Snowe, went unheeded.

For all the hype, there has been plenty of evidence, both scientific and
epidemiological, that estrogen, named a carcinogen by the FDA two years
ago, is not a wonder drug for everyone. Thirty percent of prescriptions
for estrogen remain unfilled, and the growing search for alternative
menopause products shows that increasing numbers of women are
uncomfortable with the prospect of a lifetime of swallowing synthesized
horse urine. And for all the spin, there has also been accumulating
evidence of serious side effects. As early as 1975 the FDA identified
links between estrogen and higher rates of uterine cancer. (Wyeth
responded by adding another product, progestin, to offset the risk.) In
1990 the Nurses Health Study reported that women on estrogen faced a 36
percent greater risk of breast cancer. That same year the FDA refused to
approve Premarin as a treatment to prevent heart disease, because the
company's evidence didn't convince them. The 2000 HERS study, actually
funded by Wyeth, found that hormone therapy increased risks in heart
disease patients in the first few years. (Wyeth countered that
long-term, it works.)

And people have been trying to warn us. As far back as the mid-1990s,The Menopause Industry, by Australian reporter Sandra Coney,
presented heavily researched evidence of uterine bleeding, gallbladder
disease and increased cancer rates in hormone takers. In 1997 breast
cancer specialist Dr. Susan Love's Hormone Book returned to the
link between HRT and increased breast cancer risk and came under attack
for raising an alarm. Earlier this year Cindy Pearson, executive
director of the National Women's Health Network, published The Truth
About Hormone Replacement Therapy, outlining many other
discrepancies between hormone hype and science. The medical
establishment barely paid attention.

Finally, the scientific evidence that we have now, based on two large
randomized trials, is definitive, according to one of the study's
leaders, Dr. Deborah Grady. The trials have shown that not only does HRT
do more harm than good for women with existing heart disease, but it
doesn't protect healthy women either; in fact, during the trial it
increased incidence of heart attacks, breast cancer, strokes and blood
clots--enough to have caused the study to be abandoned three years
early. And yet belief in the hormone was so strong that researchers
feared it would be unethical to put women on placebos.

How is this possible? Dr. Utian of NAMS has admitted that many different
parties--from the drug companies to their paid researchers and
spokespeople to the prescribing gynecologists--have had a vested
interest in the success of hormone replacement, and for them, he told
the New York Times, the issue is about more than data. For them,
Utian said, truth is opinion. But that seems a risky precept for
physicians to work with. It sounds like something Arthur Andersen would
say.